Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ELISSA ANN FAVATA, MD
Active Sole ProprietorELISSA ANN FAVATA, MD is a Preventive Medicine healthcare provider located in CHERRY HILL, New Jersey. NPI 1619039971 is currently active in the NPPES registry. Verify at CMS.
Preventive Medicine · CHERRY HILL, NJ
Registration Details
- NPI Number
- 1619039971
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 14, 2006 (19.655154736673 yrs)
- Last Updated
- Jul 11, 2007
- Licenses
-
25MA04036200 (NJ)25MA04036200 (NJ)MD046205L (PA)MD046205L (PA)C1-0004751 (DE)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1401 ROUTE 70 EAST, SUITE 14SOUTH JERSEY MEDICAL CENTERCHERRY HILL, NJ, 08034Browse NJ providers · Browse ZIP 08034
- Phone
- 8562161100
- Fax
- 8562160484
- Primary Specialty
-
Preventive Medicine
2083P0500X
- Additional Specialty
- Preventive Medicine
- Additional Specialty
- Internal Medicine
- Additional Specialty
- Preventive Medicine
- Additional Specialty
- Internal Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.